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Is a Spreader Graft Necessary to Fix Nasal Valve Collapse?

asked 1 year ago by 11704 in Lindenhurst
Latest answer by Thomas Buonassisi, MD
Question viewed 1,268 times
Tags: collapse, graft, spreader, valve

I had a previous rhinoplasty where a dorsal hump was removed leaving me with a collapsed internal nasal valve. The doctor said he would use a closed approach to fix my problems. He said he does not used spreader grafts, rather he uses another type of graft to support the sidewall of the nose. It seems that all of the articles I read say that this type of problem calls for a spreader graft. Is it unusual not to use one? Also would this graft would improve the crookedness of my nose as well?

30 answers to Is a Spreader Graft Necessary to Fix Nasal Valve Collapse?

+1

Spreader grafts and and finding a surgeon who is good at this.

Yes, very often patients need spreader grafts since when the hump is removed there tends to be collapse of the middle 1/3 of the nose.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+2

Spreader grafts for nasal valve narrowing.

There are many ways to improve breathing when the cause is pinching or narrowing of the side walls of the nose. Spreader grafts are thin slivers of cartilage placed or sutured between the edge of the septum just below the skin and the flat cartilaginous plate supporting the side wall of the nose. Although spreader grafts are popular, they are not the only way. It is far easier to place them using an open approach. This is complicated surgery and you should get a second... more
Oakley Smith, MD

Toronto Facial Plastic Surgeon

www.droakleysmithrhinoplasty.com

+2

Nasal Valve Collapse, Spreader versus Onlay Graft

The question you ask is simultaneously both simple and complicated. The essential truth is that both grafts will help with correction of a crooked nose and both will help with functional problems. However, there are subtle differences between the 2 options. Difference #1: Approach I do spreader grafts through a closed approach typically, but many surgeons will only place them using an open approach. If an open approach seems like too much surgery for a single graft, then many... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon
+1

Spreader Graft Often Used for Internal Nasal Valve Collapse

A collapsed internal nasal valve is often repaired with a spreader graft. I personally place these with and external approach but it can be done closed as well. A batten graft may be used as well. These are usuallly used to repair an external valve collapse. The terminology can be confusing and the surgery is quite specialized. If your surgeon is experienced trust their recommendation.
Thomas Buonassisi, MD

Vancouver Facial Plastic Surgeon

www.8west.ca

+1

Rhinoplasty procedure

It is not unusual to use spreader grafts for patients who have nasal valve collapse. These cartilage grafts can also be used to straighten the nose. It is difficult to correct this problem through a closed approach, and you may want to seek a second opinion.
Michael Sullivan, MD

Columbus Facial Plastic Surgeon
+1

A Deviated Septum is not the only cause of Nasal Airway Obstruction.

It appears that you may have had some collapse of your internal nasal valve after the initial surgery.  However, nasal airway obstruction may be due to a number of causes.  A deviated septum, enlarged turbinates, or valve collapse are all culprits of poor nasal breathing.  It is important to obtain a thorough exam by a rhinoplasty specialist to determine the cause of your poor nasal function.  Spreader grafts can help internal nasal valve collapse.  However,... more
Etai Funk, MD

Houston Facial Plastic Surgeon

www.funkfacialplastics.com

+1

Rhinoplasty for Nasal Obstruction

The answer to both of your questions depends upon what is in fact causing the nasal obstruction. There are several different causes to this and can include a deviated septum, turbinate enlargement, or valve collapse.  Valve collapse can further be classified into the external valve and the internal valve.  A spreader graft will not help in all types of valve collapse, so you must have a thorough nasal examination by a nose specialist in order to determine this... more
Jacob D. Steiger, MD

Boca Raton Facial Plastic Surgeon
+1

Correction of internal valve collapse

Spreader grafts are the best (but not the only) way to correct internal valve collapse.  It all depends on the anatomic findings in the inside of your nose.  Does using breathe right strip help you? if yes, then that is very strong indication that you have internal valve collapse.  Generally for very narrow internal valves (or collapse), spreader grafts placed via the open approach are recommended. Hope that is helpful, Dr. Vartanian
A. John Vartanian, MD

Glendale Facial Plastic Surgeon
+1

Spreader grafts, rhinoplasty

Spreader grafts are great. They help people breathe by opening the internal nasal valve. Interestingly enough, the concept for breathe-rigth nasal strips is based on this idea. They also help support the middle portion of the nose, quite well I might add. All plastic surgeons that I know and have been trained by use them routinely.
Srdjan Ostric, MD

Chicago Plastic Surgeon
+1

Nasal spreader grafts to improve breathing

Hi 11704 in Lindenhurst, Rhinoplasty has many potential maneuvers to achieve desired results. In addition, every surgeon has different methods to accomplish the goal. Spreader grafts are commonly used to improve a narrowed internal angle. Spreader grafts may be placed via an endonasal (closed) approach, however, I think most rhinoplasty surgeons use an open approach. Your rhinoplasty surgeon may want to place alternate grafts to improve your nasal breathing and appearance, such as... more
Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon
+1

Spreader grafts, alar batten grafts for collapsed or narrowed nasal valve

Spreader grafts are grafts from septal cartilage or less commonly ear or rib cartilage which are placed between the upper lateral cartilage and the septum to widen the nasal valve.   This can improve breathing and also widen this area if there is a visible depression.   Spreader grafts can also help to straighten a crooked septum that has a high deviation and make the nose  straighter.   Alar batten grafts are grafts placed under the lateral crura to add more rigidity... more
James C. Marotta, MD

Long Island Facial Plastic Surgeon

www.marottamd.com

+1

Spreader Grafte for Nasal Valve Collapse

If the diagnosis is internal nasal valve collapse, spreader grafts will improve breathing. As most things in life, there is more than one way to accomplish your goal. Some physicians would use an open technique  and different grafts. If it will make you more comfortable, get a second opinion. You mention that your nose is crooked - ask your surgeon if this is contributing to your compromised breathing.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Internal Nasal Valve Collapse In Rhinoplasty Has Numerous Methods Of Graft Correction

Spreader grafts are but one method of managing internal valve collapse in rhinoplasty, although it is by far the most common. There are other graft methods including the butterfly graft resorbable spacers and even dermal grafts instead of cartilage. Each plastic surgeon has their preferred method based on their own experience. Given your question it would be important that you understand exactly what has been recommended. What effect that method would have on... more
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

+1

Spreader grafts work

Spreader grafts are a very effective way at opening the internal valve and improving nasal airway breathing.  The cartilage used can come from your nose (septum or preserved upper lateral), ear, or in rare cases your rib.  
Farzad R Nahai, MD

Atlanta Plastic Surgeon
+1

Spreader grafts

Spreader grafts are commonly used to correct nasal valve collapse and indeed may also be useful for correction of a crooked nose especially where extensive septal work needs to be done.
Andrew Pichler, MD

Sacramento Facial Plastic Surgeon

facedr.com

+1

Spreader graft for internal nasal valve collapse

You are correct - spreader grafts are used for internal nasal valve collapse.  However, before you completely discount your surgeon - I'd encourage you to communicate with him/her.  Because he/she is the only person who has examined you, I would ask him/her to explain what they feel your anatomic problem is and how the graft will help fix this problem.  You should always feel 100% before proceeding with surgery. Dr. Cat Begovic M.D.
Catherine Huang-Begovic, MD

Beverly Hills Facial Plastic Surgeon
+1

Use of spreader grafts depends on your problem

Spreader grafts are great for preventing the middle part of the nose from becoming too narrow. I also feel that in most patients, spreader grafts also help improve the patient's breathing. However, some surgeons feel that butterfly grafts are more effective in preventing internal nasal valve collapse. I am not one of those surgeons, but most likely yours is. Regarding a crooked nose, neither graft will correct a crooked nose unless the graft is placed assymetrically or only on one side.... more
Andrew Campbell, MD

Milwaukee Facial Plastic Surgeon
+1

Correction of acute internal nasal valve angle

Correction of a tight internal nasal valve requires one of two maneuvers, placement of spreader grafts like you have proposed or rolling in of your upper lateral cartilages. Which of these maneuvers will suit you best is dependent on the width of your nasal dorsum.
Arian Mowlavi, MD

Laguna Beach Plastic Surgeon
+1

Spreader graft

If you have an internal valave collpase, usualy a spreader graft is the best solution of the affected side.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Is a spreader graft needed to fix internal nasal valve collapse?

It's a not uncommon scenerio for a patient with a nasal hump reduction to eventually develope internal valve collapse in the middle third of their nose if a spreader graft isn't placed at the time of surgery. A spreader graft can be placed secondarily, like in your case, during a separate procedure if needed. There are other types of grafts or sutures that some use to help with valve collapse. It may help if the surgeon you spoke with explained what he was planning on doing more... more
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon
+1

Spreader Grafts for Nasal Valve Collapse

Hi, Spreader grafts work well in certain types of nasal valve collapse. Sometimes surgeons will use butterfly grafts to open the nasal valve. It all depends on how extensive the collapse is. I like to use the open technique when performing nasal valve surgery as to the exact anatomic area of collapse. Best, Dr.S.
Oleh Slupchynskyj, MD

New York Facial Plastic Surgeon

www.facechange.org

+1

Is a Spreader Graft Necessary to Fix Nasal Valve Collapse?

Since we can not examine you over the internet I recommend additional in person consults. Your questions are to specific to answer over the internet. From MIAMI Dr. Darryl J. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Is a Spreader Cartilage Graft Necessary to Fix Nasal Valve Collapse?

Regarding: "Is a Spreader Graft Necessary to Fix Nasal Valve Collapse? I had a previous rhinoplasty where a dorsal hump was removed leaving me with a collapsed internal nasal valve. The doctor said he would use a closed approach to fix my problems. He said he does not used spreader grafts, rather he uses another type of graft to support the sidewall of the nose. It seems that all of the articles I read say that this type of problem calls for a spreader graft. Is it unusual not to use... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Nasal Valve Collapse and Spreader Grafts

The internal nasal valve is the angle formed between the top portion of the cartilaginous nasal septum and the upper lateral cartilages (ULC's: the structural cartilages right below the nasal bones).  In situations of surgical or physical trauma, this valve may be compromised or narrowed.  A spreader graft is a technique will allows for a wedge of "shim" of cartilage to increase the distance between the septum and ULC, thereby increasing the angle of the internal... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+1

The spreader graft is the secret to correction of internal valve collapse

The internal valve is the area along the nasal bridge just above the tip of the nose, about one third the way up from the tip. This is a critical area for nasal airflow. If you have doubt, just gently pinch this area and you will notice a large reduction in airflow. The pinch in the valve was a recognized problem in the 70"s and the spreader graft, which is used in both closed and open rhinoplasty is the standard to 'spread' open the valve and restore airflow. The grafts can... more
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Spreader grafts are the most common but not the only treatment for the nasal valve

I prefer to use spreader grafts for most patients with internal nasal valve (pinched nose) problems. Spreader grafts also work well in straightening out crooked noses. However there are a number of methods used that can also treat nasal obstruction (blockage). An experienced revision rhinoplasty specialist can discuss both their preferred methods and other options as well as open vs. closed approach with you.
Steven J. Pearlman, MD

New York Facial Plastic Surgeon
+1

Spreader graft to fix internal nasal obstruction

Spreader grafts are commonly used for internal nasal obstruction secondary to internal nasal valve narrowing/collapse.  Most rhinoplasty surgeons would discuss this option with you and explain why they would or would not choose this approach.  Depending on your nasal anatomy, there may be other options. My recommendation would be to discuss all options with your facial plastic surgeon for a better understanding of the best approach for your nose. see video
Jon E. Mendelsohn, MD

Cincinnati Facial Plastic Surgeon

www.351face.com

+1

Spreader grafts to correct valve collapse after rhinoplasty

I can see that you have done your homework.  That is great.  Valve collapse is not a single problem so there is not a single approach that will work for every patient.  If the nasal vault is too narrow and the sidewalls are collapsed inward then a spreader graft would be appropriate.  You might need other work done as well to improve your nasal airway such as septoplasty, reduction of the turbinates or lateral crural strut grafts or a lateral nasal wall reconstruction... more
Gregory Branham, MD

Saint Louis Facial Plastic Surgeon
+1

Nasal valve collapse

A spreader graft, described by Jack Sheen, MD in the '70's, has been the gold standard for a decreased airway and nasal valve collapse. If your nose is curved on the side needing the spreader graft, you will notice improved straightening of your nose. Certainly an internal/closed approach can be used, although an open rhinoplasty may allow for better visualization and precise placement of the graft.
Ricardo Izquierdo, MD

Chicago Plastic Surgeon

www.FaceAndBodyChicago.com

+1

Revision rhinoplasty with spreader grafts

The use of spreader grafts is the most typical way to treat nasla valve collapse.  You should be sure the doctor is very experienced in revision rhinoplasty.  Also, I would estimate that most would do your revision open these days.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

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